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ENVIRONMENTAL INFORMATION CalRecycle 502(IZev.6/14) Page 2 of 4 Substantial change in demand for municipal services(police, tire.water,vector control.sewage. ❑ ® ❑ etc.)? Proximity to wetlands,drainage,or bodies of water? ❑ ® ❑ GOVERNMENTAL REQUIREMENTS Befbre a final decision can be made on your Waste Tire Facility Permit Application, we must consider,as a responsible agency, the information contained in an environmental document prepared in compliance with the requirements of the CEO.A. If an environmental document has been prepared for your protect by another agency.we must consider it. Ijone has not been prepared,a determination must be made as to who is responsible for the preparation of the em,ironmental document foryour project. The following questions will aid us in the determination. Contact your city/county planning or public works department for the following information: Assessor's Parcel Number(s): 163-37-018 County'Zoning Designation: Industrial General(IG) is the project site consistent with the jurisdiction's Zoning designation? ® Yes ❑ No is the project site consistent with the jurisdiction's General Plan? ® Yes ❑ No Was an environmental document prepared for the General Plan? ® Ycs ❑ No If yes,what type of document was prepared? ® L•IR ❑ Negative Declaration Date: Was a Notice of Determination filed with city!county clerk? ® No ❑ Yes I If Yes,attach a copy. Will the city/county have to issue any permits or approvals for your project? ❑ No ® Yes if Yes,check appropriate box: ❑ Grading Permit ❑ Zoning Change ❑ General Plan Change ® Other: Use Permit No.P15-158 City of Stockton GOVERNMENT REQUIREMENTS CONN If any permits have been obtained,list permit type and permit number tier each(attach additional pages if necessary): I. Permit Type: Administrative Use Permit Permit No: P15-158 Contact: Richard Larrouy Phone: 209-9.37-8627 Dale: 5-19-15 Department: Planning Department,City of Stockton 2. Permit Type: Permit No: Contact: Phone: Date: Department: Are any additional states or federal permits required for your project? (e.g.,Federal Regulatory Commission,U.S.Forest Service, Bureau of Land Management,Soil Conservation Service,Department of Water Resources(Division of Dam Safety),Reclamation Board,Coastal Commission,State Lands Commission,etc.). For each agency from which a permit is required,provide the following information(attach additional pages if necessar ►: 1. Agency Name: Permit: Contact; Phone: Date: 2. Agency Name: Permit: